my employer is upping our insurance. They are now charging an extra ten dollars for a "plus" plan which would include your imediate family. Since my wife is employed they are now forcing her to buy insurance from her employer as well as charging me an extra $25 for her to continue using my insurance. If my wife does not take insurance through her employer she would be refused coverage in mine. However if a husband and wife both work for our company they do not both have to have insurance and there is no $25 surcharge for the spouse. In addition if a spouse has no job or works for an employer who does not offer insurance they too do not have to pay the surcharge, This seems descriminatory and unfair. Can this all be forced on me?
Social Security Lawyers
I have encountered this before, and it always struck me as a little unfair, but I couldn't ever think of a reason why it wouldn't be permitted. These types of rules go by several names, sometimes "spousal carve-out," or "working spouse surcharge," or "spousal exclusion," and they can take many forms. Sometimes, the health plan will totally exclude spouses from coverage under the plan if they have healthcare available with their own employers, and sometimes they just charge more. The federal law that controls most employee benefits, ERISA, doesn't say anything about this situation, so there's no reason to think it's illegal, even if it does seem like it should be. Generally, employers have a lot of latitude in crafting their employee benefit rules, so things like this are probably OK, unless and until a law changes.
There's an article from the Society for Human Resource Management (SHRM), the professional organization to which most HR people belong, which talks about this more. You may want to read it, as well.
To read the article, just Google the phrase "shrm spousal exclusions on the rise" and click the first link. (For some reason, if I try to link people to this article directly, the website says it requires a subscription, but if you get there from Google, you can read it for free).
Jeremy Bordelon is a licensed attorney in the State of Tennessee only, and is authorized to practice in all Tennessee State and Federal courts, and before the Social Security Administration in any jurisdiction. Please call our firm at 1-866-959-5362 if you would like to discuss your case in more detail. The answers provided on Avvo.com are for information purposes only, and should not be relied on as legal advice. This answer does not create an attorney-client relationship between us. In some jurisdictions, this answer may be construed as attorney advertising.